Kevin Lewis

February 06, 2014

Cannabis Use and Antisocial Behavior among Youth

Ioana Popovici et al.
Sociological Inquiry, February 2014, Pages 131–162

Despite the numerous efforts to curb substance use and abuse through legislation and interventions, marijuana consumption continues to be a major social problem, particularly among young adults in the United States. We provide new information on the relationship between cannabis use and antisocial behavior by analyzing a sample of young adults (aged 18–20) from the National Epidemiological Survey of Alcohol and Related Conditions (NESARC). We examine a broad set of cannabis use patterns and multiple dimensions of antisocial behaviors and test the empirical importance of two prominent criminological theories — general strain and social bond — in explaining associations between cannabis use and antisocial behavior. We include important socioeconomic, demographic, health and health behaviors, and contextual information in all regressions to control for confounding factors. Our results imply that cannabis use is positively and significantly related to antisocial behavior among young adults, and general strain and social bond theories cannot fully explain our findings. As expected, the estimated association with antisocial behavior is stronger for more frequent cannabis users.


The Effects of Alcohol on the Consumption of Hard Drugs: Regression Discontinuity Evidence from the National Longitudinal Study of Youth, 1997

Monica Deza
Health Economics, forthcoming

This paper estimates the effect of alcohol use on consumption of hard drugs using the exogenous decrease in the cost of accessing alcohol that occurs when individuals reach the minimum legal drinking age. By using a regression discontinuity design and the National Longitudinal Study of Youth 1997, I find that all measures of alcohol consumption, even alcohol initiation increase discontinuously at age 21 years. I also find evidence that consumption of hard drugs decreased by 1.5 to 2 percentage points and the probability of initiating the use of hard drugs decreased by 1 percentage point at the age of 21 years, while the intensity of use among users remained unchanged. These estimates are robust to a variety of specifications and also remain robust across different subsamples.


Trends in Alcohol and Other Drugs Detected in Fatally Injured Drivers in the United States, 1999–2010

Joanne Brady & Guohua Li
American Journal of Epidemiology, forthcoming

Drugged driving is a safety issue of increasing public concern. Using data from the Fatality Analysis Reporting System for 1999–2010, we assessed trends in alcohol and other drugs detected in drivers who were killed within 1 hour of a motor vehicle crash in 6 US states (California, Hawaii, Illinois, New Hampshire, Rhode Island, and West Virginia) that routinely performed toxicological testing on drivers involved in such crashes. Of the 23,591 drivers studied, 39.7% tested positive for alcohol and 24.8% for other drugs. During the study period, the prevalence of positive results for nonalcohol drugs rose from 16.6% in 1999 to 28.3% in 2010 (Z = −10.19, P < 0.0001), whereas the prevalence of positive results for alcohol remained stable. The most commonly detected nonalcohol drug was cannabinol, the prevalence of which increased from 4.2% in 1999 to 12.2% in 2010 (Z = −13.63, P < 0.0001). The increase in the prevalence of nonalcohol drugs was observed in all age groups and both sexes. These results indicate that nonalcohol drugs, particularly marijuana, are increasingly detected in fatally injured drivers.


Drugs and Alcohol: Their Relative Crash Risk

Eduardo Romano et al.
Journal of Studies on Alcohol and Drugs, January 2014, Pages 56-64

Objective: The purpose of this study was to determine (a) whether among sober (blood alcohol concentration [BAC] = .00%) drivers, being drug positive increases the drivers' risk of being killed in a fatal crash; (b) whether among drinking (BAC > .00%) drivers, being drug positive increases the drivers' risk of being killed in a fatal crash; and (c) whether alcohol and other drugs interact in increasing crash risk.

Method: We compared BACs for the 2006, 2007, and 2008 crash cases drawn from the U.S. Fatality Analysis Reporting System (FARS) with control drug and blood alcohol data from participants in the 2007 U.S. National Roadside Survey. Only FARS drivers from states with drug information on 80% or more of the drivers who also participated in the 2007 National Roadside Survey were selected.

Results: For both sober and drinking drivers, being positive for a drug was found to increase the risk of being fatally injured. When the drug-positive variable was separated into marijuana and other drugs, only the latter was found to contribute significantly to crash risk. In all cases, the contribution of drugs other than alcohol to crash risk was significantly lower than that produced by alcohol.

Conclusions: Although overall, drugs contribute to crash risk regardless of the presence of alcohol, such a contribution is much lower than that by alcohol. The lower contribution of drugs other than alcohol to crash risk relative to that of alcohol suggests caution in focusing too much on drugged driving, potentially diverting scarce resources from curbing drunk driving.


Unemployment, Measured and Perceived Decline of Economic Resources: Contrasting Three Measures of Recessionary Hardships and their Implications for Adopting Negative Health Behaviors

Lucie Kalousova & Sarah Burgard
Social Science & Medicine, forthcoming

Economic downturns could have long-term impacts on population health if they promote changes in health behaviors, but the evidence for whether people are more or less likely to adopt negative health behaviors in economically challenging times has been mixed. This paper argues that researchers need to draw more careful distinctions amongst different types of recessionary hardships and the mechanisms that may underlie their associations with health behaviors. We focus on unemployment experience, measured decline in economic resources, and perceived decline in economic resources, all of which are likely to occur more often during recessions, and explore whether their associations with health behaviors are consistent or different. We use population-based longitudinal data collected by the Michigan Recession and Recovery Study in the wake of the Great Recession in the United States. We evaluate whether those who had experienced each of these three hardships were more likely to adopt new negative health behaviors, specifically cigarette smoking, harmful and hazardous alcohol consumption, or marijuana consumption. We find that, net of controls and the other two recessionary hardships, unemployment experience was associated with increased hazard of starting marijuana use. Measured decline in economic resources was associated with increased hazard of cigarette smoking and lower hazard of starting marijuana use. Perceived decline in economic resources was linked to taking up harmful and hazardous drinking. Our results suggest heterogeneity in the pathways that connect hardship experiences and different health behaviors. They also indicate that relying on only one measure of hardship, as many past studies have done, could lead to an incomplete understanding of the relationship between economic distress and health behaviors.


A Sibling-Comparison Study of Smoking During Pregnancy and Childhood Psychological Traits

Jarrod Ellingson et al.
Behavior Genetics, January 2014, Pages 25-35

Prenatal exposure to substances of abuse is associated with numerous psychological problems in offspring, but quasi-experimental studies controlling for co-occurring risk factors suggest that familial factors (e.g., genetic and environmental effects shared among siblings) confound many associations with maternal smoking during pregnancy (SDP). Few of the quasi-experimental studies in this area have explored normative psychological traits in early childhood or developmental changes across the lifespan, however. The current study used multilevel growth curve models with a large, nationally-representative sample in the United States to investigate for potential effects of SDP on the developmental trajectories of cognitive functioning, temperament/personality, and disruptive behavior across childhood, while accounting for shared familial confounds by comparing differentially exposed siblings and statistically controlling for offspring-specific covariates. Maternal SDP predicted the intercept (but not change over time) for all cognitive and externalizing outcomes. Accounting for familial confounds, however, attenuated the association between SDP exposure and all outcomes, except the intercept (age 5) for reading recognition. These findings, which are commensurate with previous quasi-experimental research on more severe indices of adolescent and adult problems, suggest that the associations between SDP and developmental traits in childhood are due primarily to confounding factors and not a causal association.


Official blame for drivers with very low blood alcohol content: There is no safe combination of drinking and driving

David Phillips, Ana Luiza Sousa & Rebecca Moshfegh
Injury Prevention, forthcoming

Purpose: To determine whether official blame for a crash increases significantly at BAC=0.01%.

Methods: We examined the relationship between the driver’s BAC and the degree to which he or she was assigned sole official blame (SOB) for the crash. We analysed an official, exhaustive, nationwide US database (Fatality Analysis Reporting System; n=570 731), covering 1994–2011.

Results: Even minimally ‘buzzed’ drivers are 46% (24–72%) more likely to be officially blamed for a crash than are the sober drivers they collide with (χ2=20.45; p=0.000006). There is no threshold effect—no sudden transition from blameless to blamed drivers at BAC=0.08% (the US legal limit). Instead, SOB increases smoothly and strongly with BAC (r=0.98 (0.96–0.99) for male drivers, p<0.000001; r=0.99 (0.97–0.99) for female drivers, p<0.000001). This near-linear SOB-to-BAC relationship begins at BAC=0.01% and ends around BAC=0.24%. Our findings persist after controlling for many confounding variables.

Conclusions: There appears to be no safe combination of drinking and driving—even minimally ‘buzzed’ drivers pose increased risk to themselves and to others. Concerns about drunk driving should also be extended to ‘buzzed’ driving. US legislators should reduce the legal BAC limit, perhaps to 0.05%, as in most European countries. Lowering the legal BAC limit is likely to reduce injuries and save lives.


Breaking the Link Between Legal Access to Alcohol and Motor Vehicle Accidents: Evidence from New South Wales

Jason Lindo, Peter Siminski & Oleg Yerokhin
NBER Working Paper, January 2014

A large literature has documented significant public health benefits associated with the minimum legal drinking age in the United States, particularly because of the resulting effects on motor vehicle accidents. These benefits form the primary basis for continued efforts to restrict youth access to alcohol. It is important to keep in mind, though, that policymakers have a wide variety of alcohol-control options available to them, and understanding how these policies may complement or substitute for one another can improve policy making moving forward. Towards this end, we propose that investigating the causal effects of the minimum legal drinking age in New South Wales, Australia provides a particularly informative case study, because Australian states are among the world leaders in their efforts against drunk driving. Using an age-based regression-discontinuity design applied to restricted-use data from several sources, we find no evidence that legal access to alcohol has effects on motor vehicle accidents of any type in New South Wales, despite having large effects on drinking and on hospitalizations due to alcohol abuse.


Student Drug Testing and Positive School Climates: Testing the Relation Between Two School Characteristics and Drug Use Behavior in a Longitudinal Study

Sharon Sznitman & Daniel Romer
Journal of Studies on Alcohol and Drugs, January 2014, Pages 65-73

Objective: Fostering positive school climates and student drug testing have been separately proposed as strategies to reduce student drug use in high schools. To assess the promise of these strategies, the present research examined whether positive school climates and/or student drug testing successfully predicted changes in youth substance use over a 1-year follow-up.

Method: Two waves of panel data from a sample of 361 high school students, assessed 1 year apart, were analyzed. Changes in reported initiation and escalation in frequency of alcohol, cigarette, and marijuana use as a function of perceived student drug testing and positive school climates were analyzed, while we held constant prior substance use.

Results: Perceived student drug testing was not associated with changes in substance use, whereas perceived positive school climates were associated with a reduction in cigarette and marijuana initiation and a reduction in escalation of frequency of cigarette use at 1-year follow-up. However, perceived positive school climates were not associated with a reduction in alcohol use.

Conclusions: Student drug testing appears to be less associated with substance use than positive school climates. Nevertheless, even favorable school climates may not be able to influence the use of alcohol, which appears to be quite normative in this age group.


Time Horizons and Substance Use among African American Youths Living in Disadvantaged Urban Areas

JeeWon Cheong et al.
Addictive Behaviors, forthcoming

Transitioning from adolescence to full-fledged adulthood is often challenging, and young people who live in disadvantaged urban neighborhoods face additional obstacles and experience disproportionately higher negative outcomes, including substance abuse and related risk behaviors. This study investigated whether substance use among African Americans ages 15 to 25 (M = 18.86 years) living in such areas was related to present-dominated time perspectives and higher delay discounting. Participants (N = 344, 110 males, 234 females) living in Deep South disadvantaged urban neighborhoods were recruited using Respondent Driven Sampling, an improved peer-referral sampling method suitable for accessing this hard-to-reach target group. Structured field interviews assessed alcohol, tobacco, and illicit drug use and risk/protective factors, including time perspectives (Zimbardo Time Perspective Inventory [ZTPI]) and behavioral impulsivity (delay discounting task). As predicted, substance use was positively related to a greater ZPTI orientation toward present pleasure and a lower tendency to plan and achieve future goals. Although the sample as a whole showed high discounting of delayed rewards, discount rates did not predict substance use. The findings suggest that interventions to lengthen time perspectives and promote enriched views of future possible selves may prevent and reduce substance use among disadvantaged youths. Discontinuities among the discounting and time perspective variables in relation to substance use merit further investigation.


Alcohol Consumption and Political Ideology: What's Party Got to Do with It?

Pavel Yakovlev & Walter Guessford
Journal of Wine Economics, December 2013, Pages 335-354

Recent research in psychology and sociology has established a connection between political beliefs and unhealthy behaviors such as excessive alcohol, tobacco, and illegal drug consumption. In this study, we estimate the relationship between political ideology and the demand for beer, wine, and spirits using a longitudinal panel of fifty U.S. states from 1952 to 2010. Controlling for various socioeconomic factors and unobserved heterogeneity, we find that when a state becomes more liberal politically, its consumption of beer and spirits rises, while its consumption of wine may fall. Our findings suggest that political beliefs are correlated with the demand for alcohol.


The Influence of Discrimination on Smoking Cessation among Latinos

Darla Kendzor et al.
Drug and Alcohol Dependence, forthcoming

Background: Although studies have shown a cross-sectional link between discrimination and smoking, the prospective influence of discrimination on smoking cessation has yet to be evaluated. Thus, the purpose of the current study was to determine the influence of everyday and major discrimination on smoking cessation among Latinos making a quit attempt.

Methods: Participants were 190 Spanish speaking smokers of Mexican Heritage recruited from the Houston, TX metropolitan area who participated in the study between 2009 and 2012. Logistic regression analyses were conducted to evaluate the associations of everyday and major discrimination with smoking abstinence at 26 weeks post-quit.

Results: Most participants reported at least some everyday discrimination (64.4%), and at least one major discrimination event (56%) in their lifetimes. Race/ethnicity/nationality was the most commonly perceived reason for both everyday and major discrimination. Everyday discrimination was not associated with post-quit smoking status. However, experiencing a greater number of major discrimination events was associated with a reduced likelihood of achieving 7-day point prevalence smoking abstinence, OR = .51, p = .004, and continuous smoking abstinence, OR = .29, p = .018, at 26 weeks post-quit.

Conclusions: Findings highlight the high frequency of exposure to discrimination among Latinos, and demonstrate the negative impact of major discrimination events on a smoking cessation attempt. Efforts are needed to attenuate the detrimental effects of major discrimination events on smoking cessation outcomes.


Alcohol Exposure In Utero and Child Academic Achievement

Stephanie von Hinke Kessler Scholder et al.
NBER Working Paper, January 2014

We examine the effect of alcohol exposure in utero on child academic achievement. As well as studying the effect of any alcohol exposure, we investigate the effect of the dose, pattern, and duration of exposure. We use a genetic variant in the maternal alcohol-metabolism gene ADH1B as an instrument for alcohol exposure, whilst controlling for the child’s genotype on the same variant. We show that the instrument is unrelated to an extensive range of maternal and paternal characteristics and behaviours. OLS regressions suggest an ambiguous association between alcohol exposure in utero and children’s academic attainment, but there is a strong social gradient in maternal drinking, with mothers in higher socio-economic groups more likely to drink. In stark contrast to the OLS, the IV estimates show negative effects of prenatal alcohol exposure on child educational attainment. These results are very robust to an extensive set of model specifications. In addition, we show that that the effects are solely driven by the maternal genotype, with no impact of the child’s genotype.


Does legislation to prevent alcohol sales to drunk individuals work? Measuring the propensity for night-time sales to drunks in a UK city

Karen Hughes et al.
Journal of Epidemiology & Community Health, forthcoming

Background: By measuring alcohol retailers’ propensity to illegally sell alcohol to young people who appear highly intoxicated, we examine whether UK legislation is effective at preventing health harms resulting from drunk individuals continuing to access alcohol.

Methods: 73 randomly selected pubs, bars and nightclubs in a city in North West England were subjected to an alcohol purchase test by pseudo-drunk actors. Observers recorded venue characteristics to identify poorly managed and problematic (PMP) bars.

Results: 83.6% of purchase attempts resulted in a sale of alcohol to a pseudo-intoxicated actor. Alcohol sales increased with the number of PMP markers bars had, yet even in those with no markers, 66.7% of purchase attempts resulted in a sale. Bar servers often recognised signs of drunkenness in actors, but still served them. In 18% of alcohol sales, servers attempted to up-sell by suggesting actors purchase double rather than single vodkas.

Conclusions: UK law preventing sales of alcohol to drunks is routinely broken in nightlife environments, yet prosecutions are rare. Nightlife drunkenness places enormous burdens on health and health services. Preventing alcohol sales to drunks should be a public health priority, while policy failures on issues, such as alcohol pricing, are revisited.


Evidence of underage targeting of alcohol advertising on television in the United States: Lessons from the Lockyer v. Reynolds decisions

Craig Ross, Joshua Ostroff & David Jernigan
Journal of Public Health Policy, February 2014, Pages 105–118

Underage alcohol use is a global public health problem and alcohol advertising has been associated with underage drinking. The alcohol industry regulates itself and is the primary control on alcohol advertising in many countries around the world, advising trade association members to advertise only in adult-oriented media. Despite high levels of compliance with these self-regulatory guidelines, in several countries youth exposure to alcohol advertising on television has grown faster than adult exposure. In the United States, we found that exposure for underage viewers ages 18–20 grew from 2005 through 2011 faster than any adult age group. Applying a method adopted from a court in the US to identify underage targeting of advertising, we found evidence of targeting of alcohol advertising to underage viewers ages 18–20. The court's rule appeared in Lockyer v. Reynolds (The People ex rel. Bill Lockyer v. R.J. Reynolds Tobacco Company, GIC764118, 2002). We demonstrated that alcohol companies were able to modify their advertising practices to maintain current levels of adult advertising exposure while reducing youth exposure.


Avoidance of Cigarette Pack Health Warnings among Regular Cigarette Smokers

Olivia Maynard et al.
Drug and Alcohol Dependence, forthcoming

Background: Previous research with adults and adolescents indicates that plain cigarette packs increase visual attention to health warnings among non-smokers and non-regular smokers, but not among regular smokers. This may be because regular smokers: 1) are familiar with the health warnings, 2) preferentially attend to branding, or 3) actively avoid health warnings. We sought to distinguish between these explanations using eye-tracking technology.

Method: A convenience sample of 30 adult dependent smokers participated in an eye-tracking study. Participants viewed branded, plain and blank packs of cigarettes with familiar and unfamiliar health warnings. The number of fixations to health warnings and branding on the different pack types were recorded.

Results: Analysis of variance indicated that regular smokers were biased towards fixating the branding rather than the health warning on all three pack types. This bias was smaller, but still evident, for blank packs, where smokers preferentially attended the blank region over the health warnings. Time-course analysis showed that for branded and plain packs, attention was preferentially directed to the branding location for the entire 10 seconds of the stimulus presentation, while for blank packs this occurred for the last 8 seconds of the stimulus presentation. Familiarity with health warnings had no effect on eye gaze location.

Conclusion: Smokers actively avoid cigarette pack health warnings, and this remains the case even in the absence of salient branding information. Smokers may have learned to divert their attention away from cigarette pack health warnings. These findings have implications for cigarette packaging and health warning policy.


Parent–Child Drug Communication: Pathway From Parents' Ad Exposure to Youth's Marijuana Use Intention

Thipnapa Huansuriya, Jason Siegel & William Crano
Journal of Health Communication, forthcoming

The authors combined the 2-step flow of communication model and the theory of planned behavior to create a framework to evaluate the effectiveness of a set of advertisements from the National Youth Anti-Drug Media Campaign promoting parent–child drug communication. The sample consisted of 1,349 pairs of parents and children who responded to the first and second annual rounds of the National Survey of Parents and Youth, and 1,276 pairs from Rounds 3 and 4. Parents' exposure to the campaign reported at Round 1 was indirectly associated with youth's lowered intentions to use marijuana at Round 2. Ad exposure was associated with positive changes in parental attitudes toward drug communication and perceived social approval of antidrug communications. These two beliefs, along with perceived behavioral control, predicted parents' intentions to discuss drugs with their children. Parental intentions to discuss drugs reported at Round 1 were associated with youth's report of actual drug communication with their parents at Round 2. Frequency and breadth of the topics in parent–child drug communication were associated with less positive attitudes toward marijuana use among youth who spoke with their parents. Together, the child's attitudes toward marijuana use and perceived ability to refuse marijuana use predicted youth's intentions to use marijuana. The proposed model fit well with the data and was replicated in a parallel analysis of the data from Rounds 3 and 4. Implications for future antidrug media campaign efforts are discussed.


Pregnenolone Can Protect the Brain from Cannabis Intoxication

Monique Vallée et al.
Science, 3 January 2014, Pages 94-98

Pregnenolone is considered the inactive precursor of all steroid hormones, and its potential functional effects have been largely uninvestigated. The administration of the main active principle of Cannabis sativa (marijuana), ∆9-tetrahydrocannabinol (THC), substantially increases the synthesis of pregnenolone in the brain via activation of the type-1 cannabinoid (CB1) receptor. Pregnenolone then, acting as a signaling-specific inhibitor of the CB1 receptor, reduces several effects of THC. This negative feedback mediated by pregnenolone reveals a previously unknown paracrine/autocrine loop protecting the brain from CB1 receptor overactivation that could open an unforeseen approach for the treatment of cannabis intoxication and addiction.


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